Therein lies perhaps the biggest danger with this taboo: Politicians with mental illnesses have to hide them to continue to serve in public office and so might not seek help, putting themselves and others at risk. In 2011, Representative David Wu of Oregon resigned under the cloud of an alleged unwanted sexual encounter with a teenage girl. During the 2010 midterms, former members of his staff and campaign team now say, they feared that Wu felt too “ashamed” to take his antidepressant medication, as he swung dramatically from confused and disconsolate to impulsive, angry and sexually aggressive. (Wu, who declined to be interviewed for this article, maintained that the encounter was consensual, and she did not press charges.)

Former Representative Brian Baird of Washington, a clinical psychologist, says that while in Congress he occasionally pulled aside a colleague and privately referred him or her to a professional. “I’ve done it. I’ve seen others do it, say to a colleague, ‘You OK? You seem a little troubled,’” he says. “The simple reality is that people in a constitutional democratic republic are still human beings.” But even Baird—who periodically sought counseling himself and considered, though decided against, going on medication for depression—sympathizes with those who demurred. “If I’m back home in my district and I’m seen at a pharmacy picking up Prozac or something, I’d be worried,” he says.

In part, the lingering stigma is cultural and generational. Patrick Kennedy, the former congressman, recalls some colleagues telling him, “I come from the buckle of the Bible Belt. In my part of the country, it’s about moral issues, not medical issues. This is about character, not chemistry.” Kennedy wrote in his recent memoir, A Common Struggle, that he believes his late father, one-time presidential candidate Senator Ted Kennedy, suffered from PTSD and often self-medicated with alcohol. As a congressman, Patrick developed his own self-medicating habits to cope with mental illness—until he could no longer hide it. At 2:45 one morning in 2006, he crashed his car into a traffic barrier near Capitol Hill. He was found with his lights off, eyes glazed over, claiming to be late for a congressional vote. “My dad used to say all I needed was a good swift kick in the ass,” Kennedy says now. “I needed that, and I needed some good treatment.”

Lawton Chiles’ Prozac prescription became a campaign issue in the 1990 Florida gubernatorial race. In 2006, Rep. Patrick Kennedy, right, gave a news conference in which he said he was entering treatment for addiction to prescription pain medication.
| AP Photos

Beyond politicians’ personal health, this taboo can affect the way they govern, too, including how the federal government decides to spend nearly $1 trillion on major health programs each year. Several colleagues confided in Kennedy about their own mental illness after he announced he would get help, but in 2008, when the congressman helped the House pass a bill requiring insurance companies to cover mental and physical health care equally, he noticed that many of those same colleagues voted against the bill. “I’ve never betrayed their confidence, but of course I went up to them after the vote and I said, ‘Hey, I thought we had something where we understood what this was about,’” Kennedy says. More recently, Representative Tim Murphy, a Pennsylvania Republican who remains a practicing psychologist at Walter Reed National Military Medical Center, has been working steadily on a bill to overhaul America’s mental health care system. His efforts, he says, have been slow in part because there’s not an open dialogue around mental health. “A lot” of his colleagues, he says, “have no idea what we’re talking about and need to be educated.”

A more open discussion, and forgiving atmosphere, is precisely what some politicians and mental health professionals hope for. Saul Levin, CEO and medical director of the American Psychiatric Association, says the public should “commend” rather than punish any politician who seeks treatment for a mental illness. “If anything, I’d come out even stronger in support of them for saying, ‘I don’t want to just hide this and not take care of it,’” he says. Representative Jim McDermott, a psychiatrist by training, echoes this: “The question is not whether you’ve had the experience, it’s how you’ve dealt with it.”

Ruben Gallego’s willingness to speak candidly about his PTSD is a small test of that openness. After he returned home from his 2005 Iraq War deployment, Gallego experienced heightened anxiety and couldn’t sleep. He went to the local Veterans Affairs facility, visited drop-in clinics to talk with other veterans and had support from his family to “get mentally back together” over six months. By the time he ran for Congress, he was open about the experience. How concerned was he about the effect on his public life of admitting his struggles with PTSD? “I don’t know what people think about a member of Congress who has PTSD,” he says. “And I guess at this point I don’t really care. My job is to represent the citizens of my district as much as possible and the veterans of this country.”

If I’m back home in my district and I’m seen at a pharmacy picking up Prozac or something, I’d be worried.”

For now though, Gallego is the rare, if not the only, exception in Washington. Even in the idealistic world of Aaron Sorkin’s The West Wing, the fictional President Josiah Bartlet bows to political reality and must meet a psychiatrist in secret. “A session every now and then with a psychiatrist would have been a bridge too far,” Sorkin says.

For precedent, American politicians may need to look overseas. In 1998, Kjell Magne Bondevik, prime minister of Norway, became likely the only world leader in modern history both to disclose a mental illness publicly and to seek treatment while in office. One morning, after less than a year in office and on the eve of one of the most important government meetings of the year, Bondevik woke up unable to get out of bed and ready to resign. He saw a psychiatrist, publicly disclosed his depression and announced he would take a leave of absence to mend.

When he returned to government a month later, he continued taking medication for a time, took more weekends and nights off, and stayed vigilant to maintain his mental health. He continued to serve as prime minister until 2000 and then was chosen again in parliamentary elections in 2001, serving until 2005. “It’s very hard work and a heavy burden all the time being a leader,” Bondevik said in an interview. “If you lose sleep, if things are becoming dark for you, if you feel increasing anxiety, all of these may be signals of depression. It’s important for all leaders to take the necessary measures for keeping your most physical and mental health. There, that’s my recommendation for all leaders.”